Factors associated with head circumference and indices of cognitive development in early childhood

被引:14
|
作者
Nicolaou, Laura [1 ,2 ]
Ahmed, Tahmeed [3 ]
Bhutta, Zulfiqar Ahmed [4 ]
Bessong, Pascal [5 ]
Kosek, Margaret [6 ]
Lima, Aldo A. M. [7 ,8 ]
Shrestha, Sanjaya [9 ]
Chandyo, Ram [10 ]
Mduma, Estomih R. [11 ]
Murray-Kolb, Laura [12 ]
Morgan, Brooks [1 ,2 ]
Grigsby, Matthew R. [1 ,2 ]
Checkley, William [1 ,2 ]
机构
[1] Johns Hopkins Univ, Sch Med, Div Pulm & Crit Care, Baltimore, MD 21218 USA
[2] Johns Hopkins Univ, Ctr Global Noncommunicable Dis Res & Training, Baltimore, MD 21218 USA
[3] Int Ctr Diarrhoeal Dis Res, Matlab, Div Nutr & Food Secur, Dhaka, Bangladesh
[4] Hosp Sick Children, Ctr Global Child Hlth, Toronto, ON, Canada
[5] Univ Venda, HIV AIDS & Global Hlth Res Programme, Limpopo, South Africa
[6] Univ Virginia, Div Infect Dis & Int Hlth, Charlottesville, VA USA
[7] Univ Fed Ceara, Fac Med, Clin Res Unit, Fortaleza, Ceara, Brazil
[8] Univ Fed Ceara, Fac Med, Inst Biomed, Fortaleza, Ceara, Brazil
[9] Walter Reed Armed Forces Res Inst Med Sci AFRIMS, Res Unit, Kathmandu, Nepal
[10] Kathmandu Med Coll, Dept Community Med, Kathmandu, Nepal
[11] Haydom Lutheran Hosp, Haydom, Tanzania
[12] Penn State Univ, Coll Hlth & Human Dev, Dept Nutr Sci, University Pk, PA 16802 USA
来源
BMJ GLOBAL HEALTH | 2020年 / 5卷 / 10期
基金
比尔及梅琳达.盖茨基金会; 美国国家卫生研究院;
关键词
child health; epidemiology; paediatrics; MAL-ED COHORT; ENVIRONMENTAL ENTEROPATHY; BIRTH-WEIGHT; CHILDREN; GROWTH; INFANTS; AGE; INTELLIGENCE;
D O I
10.1136/bmjgh-2020-003427
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Background While head circumference (HC) has been related to intracranial volume and brain size, its association with cognitive function remains unclear. We sought to understand the relationship among various biological and socioeconomic risk factors, HC and cognitive development. Methods We analysed data across resource-poor settings in Bangladesh, India, Nepal, Peru, South Africa and Tanzania from the Etiology, Risk Factors and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development longitudinal birth cohort study. Participating children were enrolled and followed up between 2009 and 2014. A final sample of 1210 children aged 0-24 months were included in the analyses. The main outcomes were HC for age Z-score and cognitive, gross motor and language scores from Bayley Scales of Infant Development-III tests. Length, weight and HC were measured monthly, and cognitive tests were administered at 6, 15 and 24 months of age. To disentangle the associations between risk factors and HC from linear growth and to distinguish the direct and indirect effects of these risk factors on cognitive function, we conducted mediation analysis using longitudinal models to account for all data measured during follow-up. Results Average HC-for-age Z-score (HCAZ) was -0.54 (95% CI -0.47 to -0.62) near birth and -1.01 (95% CI -0.94 to -1.08) at 24 months. Children with higher enrolment weight (p<0.0001), higher socioeconomic score (p=0.00037) and taller mothers (p=0.00084) had higher HCAZ at all ages, while enteropathogen infection (p=0.013) and more febrile episodes (p=0.013) were associated with lower HCAZ. The associations between HCAZ and enrolment weight-for-age, maternal height, socioeconomic status or pathogen burden were partly mediated through their associations with length-for-age. HCAZ showed no association with cognitive, gross motor or language skills at 6, 15 and 24 months of age. Conclusions The main risk factors associated with HC are similar to those associated with body length, and HC is not related to cognitive function.
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页数:11
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